How to check and accurately judge internal hemorrhoids

Internal hemorrhoids is a disease in traditional Chinese medicine. From the perspective of traditional Chinese medicine, the main causes of internal hemorrhoids are wind damaging the intestinal collaterals, damp heat descending, and spleen deficiency and qi collapse. It is common in middle-aged people. From a dietary perspective, the occurrence of internal hemorrhoids is mainly due to excessive consumption of spicy, alcoholic and greasy foods. In fact, excessive childbearing in women, abdominal masses, poor blood circulation, and blood stasis can also cause internal hemorrhoids. So how do you determine whether it is internal hemorrhoids?

The diagnosis of internal hemorrhoids can also be based on routine examinations including: anal palpation, anal inspection, rectal digital examination and anoscopy. 1. Anal inspection should first check whether there is blood, pus, feces, mucus, lumps and external openings of fistulas around the anus in order to determine the nature of the lesion. For example, whether there are internal hemorrhoids, prolapsed polyps around the anus, external hemorrhoids, external openings of fistulas, and eczema. The patient is then asked to struggle as if to have a bowel movement, and the doctor uses the index and middle fingers of both hands to gently and naturally spread the anus apart to evert the anus and observe whether there are any lesions, such as the location, number, size, color, bleeding spots, anal fissures, etc. of the internal hemorrhoids. The doctor may use a special glass anal suction device to suck out the internal hemorrhoids for examination. This visual examination is sometimes more accurate than anoscopy for diagnosing anal fissures and annular hemorrhoids.

2. Anal palpation involves touching the temperature of the skin around the anus to check whether it has normal elasticity. In case of pathological conditions, such as anal carbuncle, you can feel swelling around the anus, burning skin, diffuse swelling, flatness, softness and hardness of the lump, whether there is a responsive feeling in the center, etc. For example, for anal fistula, whether a cord-like nodule can be felt, and the length, size and depth of the external opening from the anus, etc.

Clinical manifestations

Internal hemorrhoids are common in adults. The main symptom at the beginning is often painless blood in the stool. The blood is not mixed with the stool, and often drips or spurts during defecation. The bleeding is intermittent and will recur and worsen due to drinking, overwork, constipation or diarrhea. Severe bleeding can cause anemia. During rectal examination, the mucosa above the dentate line is seen to be hemispherical and raised, with a bright red, dark red or grayish white color. As the hemorrhoids grow larger, they may protrude from the anus during bowel movements or coughing. If they are not retracted in time, they may become incarcerated internal hemorrhoids, with secretions overflowing and anal swelling. Depending on the severity of the disease, it can be divided into three stages:

1. Stage I: The hemorrhoids are relatively small, such as the size of soybeans or broad beans, bright red in color, soft in texture, and do not protrude from the anus. The stool contains blood or bloody drops.

2. Stage II: The hemorrhoids are larger, shaped like red dates, dark red in color, and protrude from the anus during defecation, but can return to the anus on their own after defecation. There are a lot of drops of blood in the stool or a line of blood spurting out like an arrow.

3. Stage III: The hemorrhoids are larger, like an egg or larger, grayish white in color, and protrude from the anus during defecation or walking. They cannot be retracted on their own and generally do not bleed. Once they bleed, they are in the form of spurts. If the hemorrhoids are not retracted as soon as possible after prolapse, they are prone to incarceration, strangulation, swelling, erosion and necrosis.